Manufacturing Treatments

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I am sure you could use some extra money right now, right? Should you pick up a few extra hours at work? Maybe do some home care visits? Start writing for a website? Here’s another idea. Maybe you should create your own treatment! Creating new treatments from supposedly new ideas is pretty common these days. It seems that there is always some new certification or treatment paradigm that people are rushing to learn about. After seeing a therapist’s credentials, I often find myself checking to see what all the other letters after PT and DPT stand for. The allure of a supposedly new method, the prestige of spending time bettering oneself, and the honest desire to help our patients can combine to make getting certified in the latest and greatest sound irresistible, even before we see the appropriate vetting and scientific evidence. So let’s go over a few steps on how to manufacture a new treatment.

Step 1: The Concept

The first thing you need to do is come up with a treatment idea that has a few features:

Ensure the treatment is biologically plausible to the average patient and healthcare practitioner. If it is sufficiently plausible, you can prevent those pesky skeptics from dismissing it outright, and you can get some buy-in from our potential customers. Nevermind if it is an old idea that is repackaged with a new angle or a new idea that hasn’t been studied yet.

The idea has to sound sexy, sophisticated, and science-y. This accomplishes a few goals. You need to make the idea sound like it is going to be effective, and if you can convince your patients and therapists that the “science” is there to back it, it will make your job a little easier later on. The more elegant the idea, the easier it will be to plant the seed.

Your idea needs to be sufficiently vague. If you make your treatment idea slippery enough, you can skillfully dodge any arguments against it and you can connect it to any problem a patient might have or population that a therapist will see.

Step 2: The Development

Once you have the concept for your new treatment, you need to develop it and flesh out the ideas. Here are a few points to consider:

Base the mechanism on something that people are generally familiar with, but have not done any extensive research on. Strike the right balance between familiarity and obscurity to peak your customers’ interest.

Make sure that whatever you choose to base your treatment on is associated with a significant amount of difficulty measuring it, or better yet, choose something that can’t be measured at all.

Create your own internally consistent framework for looking at the body that all the other therapists have been ignoring, and make no attempt to externally validate it. This way, you can suggest to patients that something is wrong, as determined by your own system, and you can detect and correct it.

When describing it, throw in as many fashionable buzzwords as you can such as function, dysfunction, applied, specialized, biophysical, tensegrity, myofascial, biorhythm, biocurrent, quantum, energy etc. Really, any words that sound science-y or combine concepts from biology and physics will do. You want to make our treatment sound as sexy as possible, and the more buzzwords…the more buzz. Duh.

Cast your net wide. Your treatment needs to be able to help any person with any problem. You want your treatment to be used as widely as possible, so if it can treat the hard stuff in addition to the average aches and pains, then all the better.

Position your treatment as an adjunct technique that is used to enhance our customers’ skills, and improve outcomes. Suggesting your new treatment is nothing more than a supplement to current techniques will make your job a little bit easier later when you are asked to provide some evidence.

Work out some way to sell something, and suggest it is absolutely necessary to perform the treatment appropriately. Selling new treatment modalities is already a proven concept; just look at the shiny hunks of metal used for IASTM, the stim/ultrasound combo machines in almost every outpatient clinic, or the electro-dry needling equipment being used to zap patients.

Step 3: The Marketing

Now at this point, you may want to spend some time studying your idea, and perhaps look into performing some preliminary research. Don’t. Let’s go straight into the marketing and get people aboard the hype train. Here are some techniques and pointers that have been utilized with success:

Obviously, the first thing to do is to trademark your technique and make sure that no one else can steal your success. The last thing you need is competitors.

Create and develop your online presence. You want to have your own website and be active on all social media outlets to get the word out.

You can never promise too much. It doesn’t matter how long a person has had their problem or how severe their condition is. Don’t be afraid to suggest that you can instantly relieve their symptoms with almost 100% success. Even for patients with chronic disabilities like spinal cord injuries…they may walk again!

Get someone to give a testimonial for you. Here are a few options: any person with Dr. in their title, even if they are not a medical doctor, a desperate patient with a debilitating condition, or just an honest therapist that wants to help people.

Offer a money back guarantee, a diploma, and/or additional titles. You want to prey on the vulnerability of young therapists that honestly want to better themselves and treat their patients more effectively.

This one is key: be sure to offer as many classes in as many places as possible, and be sure to make this information available on your website.

Step 4: The Research

Now at this point you may get into a bit of a bind. Evidence-based medicine, as a movement, has made it more challenging to to promote fake treatments. But despite this you have a few ways to circumvent the standard:

Many people will not be able to critically appraise the research you produce, not through any fault of their own, but most often due to inadequate time, training, or understanding. You can use this to your advantage.

Case studies will be your best friend. Write up as many as you can. Most people will get better most of the time, via regression to the mean, natural progression of the condition, as well as contextual factors and placebo effects, in addition to whatever effects the actual treatment has. So every case study you have where the patient gets better, and includes your manufactured treatment, is a few points in your favor. Despite being a lower form of evidence and ideal only for describing unique medical conditions or situations, case studies are still regularly touted as evidence for new treatments.

If you plan on performing a trial, there are a few ways you can maximize bias. Forget about blinding, active control groups, or appropriate statistical comparisons. Don’t even think of declaring any conflicts of interest or putting your work up for peer review.

Don’t worry about comparing your new treatment to existing ones that may be already effective. Usually it is enough to show that your treatment is better than a control group that did nothing, and people will not think to compare it to things we all can do already.

Utilize surrogate endpoints. While you may not be able to show that you can actually reduce pain and improve function, there are surely other things you can measure that show improvement that may or may not even really matter to the patient.

Despite what evidence you have, make sure you suggest to everyone that your treatment is evidence-based. Most people won’t do their homework and you can get by with posting a few case studies, lukewarm trials, and a hopefully-worded systematic review. How in depth do you think anyone will read that stuff anyway?

If you don’t even want to bother doing any research, just suggest that it isn’t necessary. Explain that you see enough results anecdotally, and studying it will just be a waste of time and resources.

Step 5: The Skeptics

Undoubtedly, skeptical healthcare professionals will be critical of you and your fake treatment. Here are a few ways of dealing with them effectively:

Suggest that evidence-based medicine is a three-legged stool that takes into account of the best research available, as well as clinical expertise and patient values and expectations. Nevermind that this is a misinterpretation of Sackett’s definition that has been thoroughly debunked already. With this definition, you can justify literally any treatment, as long as patients like it and you see results.

Also suggest that because they are being critical of a treatment, they are taking away options from patients that truly need it. Nevermind that there won’t be any robust evidence that shows positive outcomes. Skeptics simply want to eliminate choices for patients.

When skeptics doubt your studies, remind them that your new treatment is only a fraction of a multimodal approach to improve outcomes and wouldn’t be effective on its own.

Continue to post testimonials, videos, pictures, and quotes from patients. Overwhelming anecdotal evidence can be enough of a distraction for patients and practitioners alike.

Even though your fake treatment may have no connection with reality, suggest that all you want to do is heal your patients, and it just doesn’t matter how you do it. You see results, and that alone is enough to justify what you do.

When in doubt, don’t be afraid to make ad hominem attacks. Accuse them of just being science nerds that have debates about meaningless statistics and are so far removed from actual patient care they are irrelevant. You are the true therapist, humbly trying to heal people.

Lastly, cast doubt on the entire enterprise of science. Suggest to critics that science is largely inadequate to determine was is true in healthcare. There are too many variables that are inherently unmeasurable, and because of this, we can’t possibly study certain phenomena. Some things are just uniquely mysterious and thus outside the realm of science, and your treatment certainly is one of them.

My New Therapy

So, here is an example of a description of my newest therapy I am going to develop; Bioelectron System Therapy, or BS therapy for short.

BS Therapy™ is an evidence-based system of evaluation and treatment, based on functional concepts from biophysical sciences, that involves the application of manual therapy to patients while utilizing highly specialized instruments designed to detect and correct areas of altered electric current, which is indicative of inflammation and injury. BS practitioners wear specially calibrated gloves with magnetic resonance detectors that are able to indicate areas where the electric current is dysfunctional, and then they can perform manual, electron-enhanced, soft tissue intervention to these areas. BS Therapy™ is a useful adjunct technique in addition to other manual therapies, modalities, and exercise, and can be utilized by physical therapists, chiropractors, osteopaths, massage therapists, bodyworkers, and many more practitioners. Altered electron currents are often the unidentified culprit in many acute and chronic conditions, and is often missed by doctors and other healthcare professionals. BS Therapy™ can be used to treat a wide range of conditions including, but not limited to, pain in the spine or extremities, degenerative conditions, strains and sprains, post-surgical conditions, neurological conditions, and even psychological conditions. BS Therapy™ is a treatment backed by science, with multiple animal studies, case studies, and trials demonstrating its effectiveness. BS Therapy™ has been clinically proven to alter the electric current within an area of injury, which may result in decreased pain. BS Therapy™ may be beneficial, in addition to other treatments, for improving your patient’s quality of life.

The BS Therapy™ Institute provides on-site education from the world’s top leading therapists in an easy-to-learn format with both didactic work and hands-on labs, with multiple courses that cover topics in musculoskeletal, neuromuscular, psychological, and immunological concentrations. Each course fills up extremely quickly, because seating is limited to less than 20 people per class. We wish to provide an intimate learning environment to allow for the best instructor-to-student ratio. Upon completion of all 10 of our base-level courses we offer a BS Therapy™ Certification, as well as the distinct honor of utilizing the BST™ credential. The BST™ credential is indicative of a commitment to clinical excellence and the constant pursuit of knowledge. The BS Therapy™ Institute is committed to providing the best courses and tools for healthcare practitioners that we can and we strive to make our products affordable. We offer discounts on courses for groups of 10 or more, as well as discounts on our MRD gloves when clinicians complete all 10 courses. BS Therapy™ may be the missing piece for your practice and your patients, so contact us today if you want to truly make a difference!

Hype Trains and Patience Ferries

Physical therapists, among other healthcare professionals, are constantly seeking to improve their skills, get an edge, and differentiate themselves from the crowd. In addition, we often face conditions that are simply hard to manage, leaving us with only a few options. This results in clinicians misplacing their focus on the next latest and greatest treatment, instead of other arguably more important things, like critical thinking, literature appraisal, and understanding the principles behind successful treatments. Many are often clamoring for a ticket onto the hype train, instead of calmly boarding the patience ferry. The profession ought to be focusing on what we see in the literature and why things work, instead of a myopic focus on the treatment du jour. Doing anything else leaves each clinician, and the profession as a whole, vulnerable to the newest treatment fads and gurus promoting nonsense.

You may think that I have chosen to focus on some of the most egregious examples of pseudoscientific practices, aggressive and dishonest marketing, and general bad behavior, and you would be right. I think the overall percentage of professionals engaging in the practices above is probably low, but not low enough. Yes, there are plenty of honest therapists creating innovative new ways to help our patients, but too often, the process goes wrong. I have personally seen examples of every one of the behaviors listed above by my fellow practitioners. Our profession, and health care in general, is brought down by these practices, and as such, we need to call them out. Unless we move in a different direction, the future of our profession will be filled with supposedly new and faddish treatments with happy patients, aggressive salesman, and unsatisfactory science. Anyone that wants to create their own treatment or certification course can easily do so, and you ought to be doing everything you can to avoid falling for the next BS therapy.